NPI | 1609899319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: LA RN078322 AP03772) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA RN078322) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2023-03-14 |